Eye on Screens: Blue Light and Digital Eye Strain

Introduction to the iHealth Summit 0:00

But for some people, if there is minor functional vision problems, this can establish better cohesion and synergy between the different visual sensory systems, and then this Can become your new normal moving forward. So I always like to say there's usually two or three exercises in here that for most people, they're like, okay, that hit the nail on the head. I know if I do this, I feel this immediate calm and I can do more for longer. And so I have many patients who take a certain activity, like eye stretches, let's say, and they say you know what, every time I brush my teeth.

because I know I'm brushing my teeth twice a day, so I'll be doing this twice today. I am being efficient and maximizing what I do, but then also I don't have to think about it or feel guilty for not doing it, I just know that I brush my tooth and do eye stretches. Welcome to the IQ Podcast. I'm Dr. Rani Banik, here to help you boost your IQ with powerful insights that connect your eyes, your brain, and your whole body wellness. This episode was recorded during the iHealth Summit, where the world's leading experts shared breakthrough insights in vision and holistic eye care.

Welcome back, everyone, to another session on the iHealth Summit. Today, we are so honored to have with us Dr. Bryce Applebaum as our guest, and he is an expert in the field of neurooptometry and vision therapy. So thank you, Dr Applebomb, for joining us today on i health summit. Such a pleasure to be here. Excited to Yes, I've really been looking forward to your topic because I know so many people have questions. I always get these questions from patients. What do I do for this issue and that issue?

We're going to pick your brain a little bit to find out how to best manage some of these issues. But before we get started on specific vision conditions, can you share with our audience what interested you in the field of neurooptometry?

Dr. Applebaumu2019s Background in Neurooptometry 1:51

How did you get start in this area? Love that you bring that up. So my background is I'm a really a product of the specialized work that, that we provide. so when I was a child, I had visual developmental delays, which meant I have trouble focusing my eyes. I didn't have poor depth perception. My eyes didn' work well together as a team. And it really made me struggle in so many areas of life. was lost on the soccer field. struggled with school and learning how to read and even had a hard time with interpersonal communication skills.

And I really attribute all of my success in life athletically, academically, even interpersonally for what was developed and trained for me, by me with vision training at an early age. And now so grateful to be able to offer that to the world in a much more advanced and more efficient way. I know you have your family is also in the eye care world. Can you share a little bit about how being in your Family, how that helped you as well? Yes, I was born to the perfect parents for my specific needs. A father was a developmental optometrist.

My mother was sensory integration based occupational therapist. And so we really, they created this kind of hybrid approach to address these challenges for me from a couple of different angles simultaneously. And now they've both been retired for a long time, but I really, I'm grateful for all that was provided for me and that they knew better so that so much more could be provided. But then on top of that, how I could take this multi-sensory learning approach and evolve that and apply that to our current patients in a way that really mimics how we use our visual system in life.

with the introduction of cognition and movement and balance and vestibular input because vision doesn't operate in isolation of all these other systems. That's such an important point. Our vision does take up a lot of our brain real estate, but it works in conjunction with so many other aspects of consciousness. So you mentioned balance, probably also hearing is important as well, and some of the other senses. Let's talk now a little bit more about neurooptometry. For our audience who may not be so familiar with what This field is what types of vision issues do you deal with as a neuro optometrist?

So neuro-optometrists really have kind of specialized training and clinical experience in vision problems, deficits that are as a result of physical disabilities, traumatic brain injury, other kind neurological insults. And really, I think neuro optometrist understand the specific visual dysfunction as it relates to patient symptoms and performance. So, whether that's the inside accommodative system, the outside muscle system I coordination system.

Understanding Accommodation and Presbyopia 4:54

The tracking system the depth perception, we can use our eyes to really wire the software in our brain to change to optimize to enhance. how we use our vision and that directly relates to what we're talking about today with eye strain and because humans are not meant to be staring at screens all day long, having our eyes and brains blasted by these little machines with the short wavelength high energy light and the crazy contrast and brightness and visual stress. So I think it's really neat to see how can access and optimize brain function through our Yeah, I'm so glad that you brought up that point, Dr.

Alba bomb, about the way our visual system developed. If you think back to our ancestors, that tens of thousands of years ago or hundreds of 1000s of year ago, they were not looking at objects up here, right? They were focused in the distance. They we're looking for threats. And so our Visual System developed in a very different way than how we use it in modern life. So you mentioned you just touched upon accommodation. Can you explain a little bit more about what accommodation is and what types of issues can happen when patients are not accommodating well or their accommodation gets fatigued?

Absolutely. So accommodation, it's the inside muscles of the eyes responsible for clarity, for making things clear, keeping them clear. I look at that as the what system. It lets us know what something is. And for what we're doing right now, having this interview on a screen, our focusing system is locked in. The muscles behind our pupils that allow things to be clear. When they're looking up close, they are locked in. And so if everyone listening were to squeeze their hands, like your hands get tired pretty quickly.

If you're squeezing like go and squeeze and let go, you can do it for much longer. The tension over time with the accommodation system or the focusing system that's locked-in for too long, That's the root cause of so many symptoms and problems and visual fatigue and eye strain and irritation. Because like you said, we're not meant to be scanning and focusing and converging and tracking up close. We're meant be doing this in the distance, looking for dinner in danger and exploring in nature. But now we've evolved to have to make these very intricate, careful eye movements on this very high stress situation with engaging with screens.

Yeah, thank you for clarifying that. And I wanted to also expand on that a little bit. It's not just screen time, right? Because we do many other tasks up close. Reading, for example. Before we had our screens, even reading for long periods of time with a hard copy of a book or a magazine can put a strain on our eyes. Absolutely. And anything that is approaching us or really with sustained near visual concentration that, is flipping the switch to get our accommodation or our focusing system involved.

So many problems emerge where there's difficulty doing that. We can't maintain flexibility. One eye starts to focus differently than the other. Our brain starts talking to a friend or a loved one up close, we have to focus our eyes to make their face clear. And it should be this automatic unconscious process. But for so many people, it steers away from that because of how difficult that can be and how much we're asking of our eye brain connection. Absolutely. It is a very dynamic system, our accommodation, and it does change during life.

Can you explain a little bit about what happens as individuals get a bit older, let's say into their late 40s, 50s? What happens with accommodation? How does that impact a person's visual experience? So Dr. Rani, you and I have decades before that happens for us, of course, because I wish it's already happened to me. So anatomically the focusing muscles, the lens inside of our eye, they become more rigid and less flexible as we age. And so what that means is a lot of people start to notice at that age period, you mentioned your arms aren't long enough and we have to start the whole thing's farther away from us because it's hard to use that focusing system, which we can look at as a old school camera.

We want it to be on autofocus the lens, but when it on manual focus or when the focusing aperture becomes more sluggish. where there's more effort required and it's harder. And then oftentimes we reach for reading glasses or support in the form of lenses or prism or whatever. I'm a little bit of the outlier in eye care world in that I truly believe and see on a daily basis that we can do specific work to not make that deterioration be as fast, to slow it down, so sometimes even stop it and make it so we're not dependent on all these other support systems, because just like any muscles in our body, if we stop using them, we lose voluntary control.

Yet we can maintain strength and flexibility and stamina with the right work, with Mm-hmm. I love your approach, Dr. Applebaum. This is something, this accommodative change that happens with age. We call it presbyopia in the eye care world. But it happens to everyone, but there are so many ways to manage it. Yes, people can choose reading glasses or multifocal contact lenses, for example, progressive lenses. There are many optical options for dealing with this issue. What I'm hearing from you is that there are things people can do whether they be training exercises or other adaptations to help them function better when they're at that distance, whether it's up close or intermediate.

Is that safe to say? That is safe and accurate to and it is a little hyperbolic because a reactive eye care approach would say that's not true. But a proactive approach would say, absolutely, we can develop better eye brain coordination and have patients in their sixties, seventies even a few in the early eighties who are doing work every day, but not needing reading glasses. And the proof has been the pudding there where. You know, we can put in effort and specific work for specific eye exercises that are needed to help engage those systems and get the feedback of what it

What Digital Eye Strain Feels Like 11:30

feels like, what It looks like how the eyes work together and the brain turns onto that information and then be able to reproduce that with with time, with fatigue, With near demands. And so absolutely, at a minimum, We can do work so that our help with reading glasses doesn't get, we don't need stronger reading glasses in the short term. And in many cases we can make it so we're less dependent on that support as we could do more with less. I'm sure you've made some members of our audience so hopeful.

I hope so. With those words, let's shift a little bit to talking about much of your day is spent on screens. Depending on which source you read, some sources say most adults spend seven hours a day on a screen, and some say 10 hours or more. Regardless, a lot of life is on the screen. In the eye care world, we talk about the syndrome called digital eye strain. Can you explain, Dr. Appelbaum, what are some of the cardinal features of this syndrome and what may be the underlying reason why some these symptoms may develop from being on screens?

Would be honored to so that digital eye strain also known as digital vision disorder or computer vision syndrome. There's lots of names, but really these are labels to describe a cluster of symptoms and vision related problems that result from prolonged screen use. And so it often includes eye strain or eye pain, blurry vision, headaches, dry eyes, neck or upper back or shoulder pain. A lot of people have now heard the term tech neck where we're adjusting our body, leaning in to compensate for what our visual system's not doing as well as it could or should.

It can be light sensitivity, it can double vision. it Can be distorted vision really this level of discomfort It often appears to increase with the increased amount of time spent on screens, but it doesn't have to. I have patients who it's instantaneously they're looking at a screen and all of a sudden like the symptoms emerge and it is miserable. So really viewing a computer or any digital screen, it makes the eyes work harder and much differently in comparison to reading a printed page, let's say.

And many factors play a role into that, but it's the screen brightness, the lighting, your posture, and the viewing distance, body positioning, glare on the screens, angle, contrast between the letters in the background. There's so much that plays a But really, it's often the person who has uncorrected functional vision problems that they didn't even know about. The screens exacerbate the symptoms and increase the severity of symptoms. But I think even backing up to what we were talking about before that what I'm seeing all day every day is this time under tension.

and this focusing stamina and eye coordination demand that it's just too much for so many people. And really the symptoms are signals or signs of what you're doing currently, your body and your brain are not able to withstand. Mm-hmm. No, those are such important points. And I wanted to just expand a little bit about what you said about timing. Yes, for many people, it's that really prolonged screen time that may elicit some of these symptoms of digital eye strain. But for some people it is instantaneous.

Why do you think different people have different, I guess you could say, endurance times when they're on screens? Is that something within their eyes? It's something else going on? what is limiting their time on a screen. To me, it's their brain and everybody's brains are sensitive to different things at different levels. And there's a way for us to measure somebody's just noticeable difference or their kind of sensitivity to certain visual stimuli and the threshold for which the brain, and I start to freak out versus something below that, It's okay.

I think how we filter and process and use the information that our eyes sends our brain That's really what dictates how much of a stress response there is to our world and how our autonomic nervous system steps into that fight or flight response. And from a visual perspective, you know, when that occurs, as you better than anybody, Dr. Rani, our pupils widen and we get this tunnel vision effect when we're under stress. That really overly drives this mismatch between the inside and outside muscles of the eyes to start to be in this tug of war with each other.

I mean, I have patients who literally cannot open their eyes when they're in life, but of course on a screen because they are in this massive state of fight or flight and they literally shutting down input being received from their dominant sensory system, from vision, because the brain can't filter all of the sensory input at the same time. Mm hmm. No, there is so much to unpack in what you just said, Dr. Applebaum. I have so many questions. You mentioned stress, you mentioned the autonomic nervous system, the balance between the internal and external muscles of the eyes.

We are going to get to all of those topics and unpack all of this. And also, Dr. Apple Mom is going to share some of his best insights on how to manage digital eye strain in just a few minutes. We are going take a very short break here from one of our sponsors and be right back on the Eye Health Summit. So stay tuned. Hello, I'm Dr. Rani and I am here to talk about something we often take for granted, our vision. In my book, Beyond Carrots, Best Foods for Eye Health A-Z, i delve into how crucial it is to be proactive about your vision health.

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Stress, Fight-or-Flight, and Visual Dysfunction 18:30

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The Agless Eyes bundle, see the world with clarity and confidence. Welcome back, everyone, to the Eye Health Summit. Today, we're chatting with Dr. Bryce Appelbaum about eye strain, in particular, digital eye-strain. So, Dr Applebaum, earlier you mentioned that stress and our autonomic nervous system can play a role, especially when we are putting a lot of demands on our eyes. Can you explain a little bit more about those two aspects of eye straining? Yes, so we all know about, we've all heard about the fight or flight response and the sympathetic and parasympathetic interactions that take place.

And really so many aspects of life can elicit stress on the individual and it's completely dependent on a person. But when that happens from a vision perspective, We use our brain a very different way than it is wired with our visual system. And so what that means is when we're looking at something, we were thinking about what it is and where it. And hopefully that that information is equal. So we are able to see clear images and single images at the same time. But when are under stress and we become this hyper focal camera that kind of locks into what's right in front of us, it literally overrides systems in ways where we normally wouldn't have that response.

So very often people develop this maladaptation or this bad habit where they start to under focus their eyes or focus the rise of different planes or converge their rise and point them at a different place and where the page is because there's all this rivalry or competition between both eyes, between the central and the peripheral, and between inside and outside muscles. And so rather than avoid the task, which is not what any of us are doing, we're coming back to screens for more and more, rather then avoid it we find a way to resolve that confusion.

So the vast majority of functional vision problems are actually brain problems manifesting in the eyes. If addressed on a brain basis, Literally anybody can do the right work with the motivation and with compliance to optimize and enhance their brain and specifically their visual system to be able to develop a foundation to thrive in this digital world that we all live in. Mm-hmm. That is, again, so hopeful to know that there are options and there ways to integrate better. So again there's this maladaptation that can happen within the brain that also affects some of the muscles in and around the eyes.

Let's talk a little bit about something that you've created to help people solve this issue of digital eye strain. So to help many people like you, if you've experienced digital eye strain, Dr. Applebaum has designed a program, which again helps people adjust to some of these maladaptations and empowers them with the knowledge and the strategies to overcome some these challenges. Can you tell us a little bit about your program Dr Applebomb? Absolutely.

ScreenFit Vision Training Program 23:00

So we all want to be screen fit, right? We all wanna be able to have the same energy and endurance on screens as we do with so many other aspects of life. This program is called Screen Fit and it's an online vision training program designed to help minimize the damage that screens have on vision reduce symptoms associated with screen time, and promote healthy visual habits during extended screen use. And most importantly, it teaches you the essential visual skills needed and necessary to have the foundation to be visually ready for the digital world that we're all in.

So there's two different courses, each course has 30 different lessons in it. Each lesson is literally a video of me describing what to do with the patient. And then the intention is put the screen away. and do the activity. So we don't want more screen time to treat screentime, but it's more of a educational protocol of here's how you do a near far focus activity, walks you through it, has a printout of what the directions are, and then it asks you to do it. And so it is one new lesson each day.

Each lesson should take 10 to 15 minutes. It's crazy every time I say this, we've had 100% of people who have gone through this see a reduction in symptoms and we have incredibly high volumes of people going through this program. So it's like a body weight workout program for your eyes rather than going to the gym, relying on individualized care, all the right equipment and procedures and protocols. That's always going give you better results faster. Working with somebody one-on-one, who knows what they're doing, that's going to get you to the best place.

But ScreenFit can be an amazing opportunity to move you in the right direction, to make you more mindful with your visual system, and to really be more proactive with maintaining the stamina and flexibility and knowing what to do to be there so we can handle screen time that we're all under. That is amazing to know that the individuals who've gone through your program, 100% of them have noticed an improvement. That's phenomenal. Congratulations, that's really incredible. I appreciate that. and hopefully many more will be interested in pursuing this.

I have a few questions about the program. So you said that there are 30 different trainings and so people have to practice some of these exercises. Does that mean that they're doing these exercise only once or they doing them multiple times or maybe one layered on top of the other? How does it work? Because I can imagine if someone's thinking, oh my goodness, I've to do 30 exercises to be able to use my computer, it can get a little bit overwhelming. Absolutely. And I love that you bring this up.

So thank you. It really depends on the person, where they are in development, in their visual journey, and what their goals are. Just like we exercise our body, we should be exercising our visual system. For some reason, people think that eye exercises don't work, even though those are the same people saying that normal exercise doesn't It works. You just have to do the right stuff and know what to deal. So in this scenario, I think for many people, this can reboot the visual system and you go through screen fit once or even a good portion of screen, but not even the whole thing.

And you may start to notice comfort and a reduction of symptoms. Oh, wow. This helped a lot for the short term. But if you're still pounding your visual brain with 10 hours a day on a screen and then not doing eye exercises in the future, probably these symptoms are gonna come back unless you shift or change the visual stress that you're under. But for some people, if there is minor functional vision problems, this can establish better cohesion and synergy between the different visual sensory systems, and this then can become your new normal moving forward.

So I always like to say there's usually two or three exercises in here that for most people, they're like, okay, that hit the nail on the head. I know if I do this, I feel this immediate calm and I can do more for longer. And so I have many patients who take a certain activity, like eye stretches, let's say, and they say you know what, every time I brush my teeth, because I know I'm brushing my teeth twice a day. So I'll be doing this twice today. I am being efficient and maximizing what I do. But then also I don't have to think about it or feel guilty for not doing it.

Just know that I brush my tooth and do eye stretches. Or when I go to the bathroom, I use near-far focus. When I stop light, whatever. It's really bringing vision work and eye-brain connection work to top of mind, to the forefront so that this is something we're mindful with. But I would argue we should be exercising our bodies indefinitely. And so from a vision perspective, we should also be doing the same with our visual system unless you're somebody who's living on a deserted island picking coconuts all day and looking out into the distance, then you not gonna have functional vision problems because there wouldn't have been that need emerged.

Thank you for clarifying that. Could you give us our audience maybe one or two examples of the types of exercises people can perhaps do for eye strain? Would love to. So I mentioned near far focus. Let's talk about the near-far-focus activity. This is like doing push-ups for your focusing system. What you're going to do is you are going cover up an eye with one hand and then grab some sort of near target, but you can literally use a pen or your finger. You want to bring your fingers close to your eye as you, until it's a little blurry and stop and try and make it clear.

And when you're trying to make it clear, think about how you are looking really close, you stimulating your focusing system, those inside muscles we spoke about are locking in, your pupils getting smaller and you looking at the pad of your finger. You want to hold it for five seconds. And then after five second, look all the way across the room, ideally 30 or so feet away plus, and relax the focus and look far and throw it out into the distance and looks soft. Then you come back to your finger and go hard for 5 seconds and back in the distant soft for fives.

So it's a gross stimulation, relaxation, stimulation relaxation. You wanna do it the same amount of time with your right eye as you do with you left eye. And many people listening will probably recognize that in doing this, you notice, hey, I can actually focus my left eye a little bit closer,

Eye Exercises and Daily Habits 29:30

or my finger can be a bit a closer than it is with my right eye. And so what that means is under two eye conditions, your likely focusing those inside muscles at different planes because it's probably too hard to focus them at the same plane. In doing that, even if you did this let's say four days a week, And after a week or two weeks, you can bring your finger a millimeter closer. Some people say millimeters, that's nothing. Why would I do this? But if you're doing this for over time and those millimeters turn into centimeters and then turn to inches, learning how to see closer for longer with better clarity and so this all compounds on itself and it's not the you have to do the 30 lessons every day even doing one or two things is better than doing nothing even getting your body moving is Better than not exercising I think just starting to move there it seems like these exercises they're not very burdensome in terms of time commitment you could probably do this near far focusing within a minute if you 30 seconds on each eye and then go about your day or stack this particular exercise maybe with a habit like you said you do it when you're doing another activity and so it can be incorporated into your Day not just when your on a screen is that right Dr.

Appelbaum? You got it really all 30 in the first course you don't need any equipment There's three of them that have things to print out that different charts that we ask you to do things with, but you can also do it on the device. But this is really intended to be body weight work or no equipment necessary work so that this can be just a part of your routine and part. Incredible. Thank you for sharing that exercise. I have an account myself, so I'm going to look forward to checking out some of the other exercises you suggest.

So Dr. Applebaum, throughout the iHealth Summit, we have been busting myths and misconceptions about vision. Is there any particular myth that you oftentimes hear from your patients that, you say, oh, that's just not true and that Oh, I love this. Yes, and I would say it's a similar myth that I often hear from doctors as well. And that is that many doctors, many people say screens don't ruin your eyes. I'd say technically, it is not the screen. It is your internal response to the visual stress associated with the screens and not having the right foundation in place or essentially not being visually ready for screen engagement.

So let's not blame the screen. Let's blame what we have in place in terms of functional visual skills and abilities and what need to develop to be able to thrive in this digital world. Oh, thank you for sharing that insight. It is so important to realize that it is some of these issues that people have on screens. There is control, right? We can retake control with some re-enable functionality. Dr. Appelbaum, we are nearing the end of our time together. You've shared so many incredible insights.

I'm sure some people's minds were just blown by what you said and they have a lot more questions or perhaps they're interested in seeking more help and more resources. So if anyone wanted to find you, follow your work, maybe try out screen fit or maybe even become a patient, how could they find Thank you for offering that so all everything we do is housed on my practices website, which is www.myvisionfirst.com and screen fit is on there, but you can also go to www dot screenfit. com. It's got its own website and his own animal.

And then also on social media, Instagram is probably our best platform, and it's just Dr.

Myths, Resources, and Closing Remarks 33:30

Bryce Applebaum, but I spell Applebomb not like Apple. So it is A-P-E-L, not L-e, because my ancestors wanted to make life difficult for everybody. But it was all there and easy to find us and see some kind of actionable take homes with what we're doing. Wonderful. We will share all of those links right below your interview so anyone can find you. So, Dr. Applebaum, throughout the iHealth Summit, we have been busting myths and misconceptions about vision. So is there any particular myth that you oftentimes hear from your patients that, you say, oh, that's just not true and that just love to bust today or dispel today?

Oh, I love this. Yes, and I would say it's a similar myth that I often hear from doctors as well. And that is that many doctors, many people say screens don't ruin your eyes. I'd say technically, it is not the screen. It is your internal response to the visual stress associated with the screens and not having the right foundation in place or essentially not being visually ready for screen engagement. So let's not blame the screen. Let's blame what we have in place in terms of functional visual skills and abilities and what need to develop to be able to thrive in this digital world.

Oh, thank you for sharing that insight. It is so important to realize that it is some of these issues that people have on screens. There is control, right? We can retake control with some re-enable functionality. Thank you again Dr. Alpabon for being a guest on the iHealth Summit. You've shared so many incredible insights and I look forward to learning more from you by trying out ScreenFit myself and i hope some of our audience members also check it out. Such a privilege being here. thank you for having me.

Absolutely and thankyou for joining this episode on i health summit. We will see you all next time so stay tuned. So refractive surgery really is the ability to take somebody who's currently dependent on glasses or contact lenses and provide them with a surgical solution to help them get rid of those glasses and contacts, if not 100% of the time, a majority of time. The original refracted surgery field was cataract surgery. And so think of our grandparents having cataract surgery in their 70s and 80s, and they would have this opacification of their lens over time.

And to have the regain vision, we would remove it and put a lens implant in its place. They would be able to get to not only have better vision but also be given to their glasses in many instances and be seen in the distance like they couldn't see before. Thank you for tuning in to the IQ Podcast. I hope you enjoyed today's episode and learned something new to help you boost your IQ. Leave us a review and share the podcast with your family and friends. Stay connected with me for more eye-opening insights on eye health, nutrition and lifestyle.

Until next time, keep your vision clear and your iQ sharp.